定义为血小板大小异质性的指标,在(亚)临床疾病中,血小板分布宽度(PDW)仍然是血小板功能特征不佳的标志物.我们目前在Moli家族队列中验证了PDW是P-选择素依赖性血小板活化的标志物。通过流式细胞术检测新鲜采集的静脉血中的血小板结合P-选择素和血小板/白细胞混合聚集体,在体外血小板活化之前和之后,在未刺激和LPS或TNFα刺激的全血中评估凝血时间。在血小板功能分析仪(PFA)-100中测量闭合时间(CT)。多变量线性混合效应回归模型(随年龄,性别和血小板计数作为固定和家庭结构作为随机效应)显示PDW与血小板P-选择素呈负相关,血小板/白细胞聚集体和血管性血友病因子(VWF),用PFA-100CT肯定,和LPS和TNF-α刺激的凝血时间。除了VWF,所有的关系都是性别独立的.相比之下,在平均血小板体积(MPV)和这些变量之间没有发现相关性.PDW似乎很简单,离体和体外P-选择素依赖性血小板活化的有用标志物。对较大队列的调查将定义PDW作为血栓炎症疾病的风险预测因子的有用性,其中活化的血小板起作用。
Defined as an index of platelet size heterogeneity, the platelet distribution width (PDW) is still a poorly characterized marker of platelet function in (sub)clinical disease. We presently validated PDW as a marker of P-selectin dependent platelet activation in the Moli-family cohort. Platelet-bound P-selectin and platelet/leukocyte mixed aggregates were measured by flow cytometry in freshly collected venous blood, both before and after in vitro platelet activation, and coagulation time was assessed in unstimulated and LPS- or TNFα-stimulated whole blood. Closure Times (CT) were measured in a Platelet Function Analyzer (PFA)-100. Multivariable linear mixed effect regression models (with age, sex and platelet count as fixed and family structure as random effect) revealed PDW to be negatively associated with platelet P-selectin, platelet/leukocyte aggregates and von Willebrand factor (VWF), and positively with PFA-100 CT, and LPS- and TNF-α-stimulated coagulation times. With the exception of VWF, all relationships were sex-independent. In contrast, no association was found between mean platelet volume (MPV) and these variables. PDW seems a simple, useful marker of ex vivo and in vitro P-selectin dependent platelet activation. Investigations of larger cohorts will define the usefulness of PDW as a risk predictor of thrombo-inflammatory conditions where activated platelets play a contributing role.